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Cross Finger Test

Test, Exam and Sign Description

Historical Overview

  • The origins of the cross finger test are unclear, perhaps because it is so easily noticed by patients.

Description

  • The patient’s inability to cross his/her middle finger over his/her index finger.1

Pathophysiology

  • Loss of function in the second and first dorsal interosseous muscles.1

Instructions

  • Determine whether the patient can cross his/her middle finger over his/her index finger.

Variations

  • No variations have been studied, but patients may differ in the degree to which they can cross their fingers

Related Signs and Tests1

  • Froment’s sign
  • Jeanne’s sign
  • Bouvier’s sign
  • Duchenne’s sign

Diagnostic Performance Characteristics

  • The diagnostic performance characteristics of the cross finger test have not been well studied.
Presentation Photos and Related Diagrams
  • Normal cross finger test which patient can do because the ulnar innervated intrinsics are functioning normally.
    Normal cross finger test which patient can do because the ulnar innervated intrinsics are functioning normally
Definition of Positive Result
  • A positive result occurs when the patient cannot cross his/her middle finger over his/her index finger.
Definition of Negative Result
  • A negative result occurs when the patient can cross his/her middle finger over his/her index finger in a normal manner.
Comments and Pearls
  • The cross finger test may be easier to administer in children or in the presence of an acute injury than are other related tests.2
  • The cross finger test is a test of the intrinsic muscles of the fingers. By combining it with tests of the extrinsic muscles, the level of ulnar injury can be determined.3
Diagnoses Associated with Tests, Exams and Signs
CUBITAL TUNNEL SYNDROME
CERVICAL RADICULOPATHY
References
  1. Doyle JR. Hand and Wrist (Orthopaedic Surgery Essentials Series). Philadelphia: Lippincott Williams & Wilkins, 2006.
  2. Earle A, Vlastou C. Crossed fingers and other tests of ulnar nerve motor function. J Hand Surg Am 1980;5(6):560-5. PMID:7430600
  3. Culp R and Jacoby SM. Musculoskeletal Examination of the Elbow, Wrist, and Hand: Making the Complex Simple. Thorofare: Slack Inc., 2012.